Hirayama T, Tada H, Katsuki M, Yoshida E
Department of Orthopaedic Surgery, Asahikawa Medical College, Japan.
Clin Orthop Relat Res. 1994 Dec(309):201-7.
To reconstruct the area from the brachial plexus to the upper arm, pedicle latissimus dorsi muscle transfer was performed in 16 patients. Nine patients underwent functional bipolar transfer for reconstruction of elbow flexion. The surgical results were satisfactory in 6 patients, but were unsatisfactory in 3 because of an incorrect preoperative assessment of the strength of the latissimus dorsi muscle and an unsuitable length of transferred muscle in 2 patients, and because of progression of spastic paralysis caused by cervical myelopathy in the third patient. Seven patients with skin loss and an unstable scar underwent aesthetic unipolar transfer in which the exposed nerve, neurovascular bundle, bone, and joint were covered by a musculocutaneous flap with good vascularity. The surgical results were successful in all 7 patients. Infection was present before transfer in 4 of the 16 patients, but it was successfully treated by simultaneous radical debridement of the infected wound and latissimus dorsi transfer.
为了重建从臂丛神经到上臂的区域，对16例患者进行了带蒂背阔肌转移术。9例患者接受了功能性双极转移以重建肘关节屈曲。6例患者的手术结果令人满意，但3例不满意，其中2例是因为术前对背阔肌力量评估不正确以及转移肌肉长度不合适，第3例是因为颈椎病导致的痉挛性瘫痪进展。7例有皮肤缺损和不稳定瘢痕的患者接受了美容单极转移术，术中用血管丰富的肌皮瓣覆盖暴露的神经、神经血管束、骨骼和关节。所有7例患者的手术结果均成功。16例患者中有4例在转移术前存在感染，但通过同时对感染伤口进行彻底清创和背阔肌转移术成功治愈。
